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Hepatobiliary surgery

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https://www.readbyqxmd.com/read/28527946/the-microbiome-and-hepatobiliary-pancreatic-cancers
#1
Kosuke Mima, Shigeki Nakagawa, Hiroshi Sawayama, Takatsugu Ishimoto, Katsunori Imai, Masaaki Iwatsuki, Daisuke Hashimoto, Yoshifumi Baba, Yo-Ichi Yamashita, Naoya Yoshida, Akira Chikamoto, Hideo Baba
The human intestinal microbiome encompasses at least 100 trillion microorganisms that can influence host immunity and disease conditions, including cancer. Hepatobiliary and pancreatic cancers have been associated with poor prognosis owing to their high level of tumor invasiveness, distant metastasis, and resistance to conventional treatment options, such as chemotherapy. Accumulating evidence from animal models suggests that specific microbes and microbial dysbiosis can potentiate hepatobiliary-pancreatic tumor development by damaging DNA, activating oncogenic signaling pathways, and producing tumor-promoting metabolites...
May 17, 2017: Cancer Letters
https://www.readbyqxmd.com/read/28523565/blood-brain-barrier-permeability-is-exacerbated-in-experimental-model-of-hepatic-encephalopathy-via-mmp-9-activation-and-downregulation-of-tight-junction-proteins
#2
Saurabh Dhanda, Rajat Sandhir
The present study was designed to investigate the mechanisms involved in blood-brain barrier (BBB) permeability in bile duct ligation (BDL) model of chronic hepatic encephalopathy (HE). Four weeks after BDL surgery, a significant increase was observed in serum bilirubin levels. Masson trichrome staining revealed severe hepatic fibrosis in the BDL rats. (99m)Tc-mebrofenin retention was increased in the liver of BDL rats suggesting impaired hepatobiliary transport. An increase in permeability to sodium fluorescein, Evans blue, and fluorescein isothiocyanate (FITC)-dextran along with increase in water and electrolyte content was observed in brain regions of BDL rats suggesting disrupted BBB...
May 18, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28508279/the-coexistence-of-both-replaced-proper-hepatic-and-gastroduodenal-arteries-due-to-the-common-hepatic-artery-absence
#3
Konstantinos Natsis, Maria Piagkou, Nikolaos Lazaridis, Georgios Koimtzis, Stylianos Apostolidis
Anatomical variants of the celiac trunk (CT) branches and especially these of hepatic arteries (HAs) are among the most common variants of the arterial tree. The knowledge of the wide variability in hepatic arterial supply is of paramount importance in hepatobiliary, pancreatic, gastric, and esophageal surgery, as well as in liver transplantations. The purpose of this case report is to describe a rare variant discovered during abdominal dissection of a 74-year-old male cadaver of Greek origin, in which the common hepatic artery was absent and its branches, the proper hepatic artery (PHA) and the gastroduodenal artery (GDA) had an aberrant and separate origin...
May 15, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28505585/giant-hepatocellular-carcinoma-with-bone-metastasis-in-a-young-adult-emerged-from-pigmented-adenoma-with-beta-catenin-activation-a-case-report
#4
Sebastian Lünse, Paula Döring, Claus-Dieter Heidecke, Lars Ivo Partecke
INTRODUCTION: Hepatocellular carcinomas (HCC) that are very large in size are a very rare finding in young adult. The malignant transformation of a pigmented hepatocellular adenoma (HCA) with beta-Catenin activation is a possible cause for appearance of HCC. PRESENTATION OF CASE: We present the case of a 33-year-old male with a huge HCC with bone metastasis, emerged from pigmented HCA with beta-Catenin activation. As a two-stage surgical procedure, a left hepatectomy followed by a partial rib resection was performed...
May 3, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28498235/hospital-minimally-invasive-surgery-utilization-for-gastrointestinal-cancer
#5
Meredith C Mason, Hop S Tran Cao, Samir S Awad, Farhood Farjah, George J Chang, Nader N Massarweh
OBJECTIVE: The aim of the study was to evaluate the impact of receiving care at high minimally invasive surgery (MIS)-utilizing hospitals BACKGROUND:: MIS techniques are used across surgical specialties. The extent of MIS utilization for gastrointestinal (GI) cancer resection and impact of receiving care at high utilizing hospitals is unclear. METHODS: This is a retrospective cohort study of 137,581 surgically resected esophageal, gastric, pancreatic, hepatobiliary, colon, and rectal cancer patients within the National Cancer Data Base (2010-2013)...
May 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28491882/portal-vein-thrombosis-in-the-setting-of-newly-diagnosed-cushing-s-syndrome
#6
Alexandria D McDow, Anju Gurung, Rama Poola, Carmel Fratianni, Marc Garfinkel, Michael G Jakoby
The hallmark manifestations of Cushing's syndrome (CS) are well known, but hypercoagulability is perhaps least recognized. Patients with CS are at increased risk of both spontaneous and postoperative thromboembolism, with the significant majority of events occurring in the lower extremity and pulmonary venous circulations. We present a case of portal vein thrombosis (PVT) occurring in the setting of newly diagnosed CS due to a left adrenal adenoma. Factor VIII activity was approximately 2.5-fold elevated, a known mechanism by which hypercortisolemia predisposes to venous thrombosis...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28486007/concomitant-laparoscopic-perisplenic-artery-ligation-facilitates-surgery-for-hepatobiliary-disease-coexisting-with-portal-hypertension
#7
Youlong Wang, Fei Chen, Yajuan Chu, Xiaofang Tan, Jingwang Tan, Wenbin Ji
BACKGROUND: Although liver cirrhosis with portal hypertension (PH) contributes significantly to morbidity and mortality in abdominal surgery, many authors still consider this disease as an indication for surgery. In many reports, however, numerous treatment modalities focus on hypersplenism secondary to PH, irrespective of splenomegaly and PH. The proven benefits of laparoscopy seem especially applicable to patients with this complex disease. This study evaluates the safety and efficacy of laparoscopic perisplenic artery ligation (SAL) in patients with hepatobiliary disease and PH...
May 9, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28484186/index-of-convexity-a-novel-method-for-assessing-liver-functional-reserve-using-technetium-99m-galactosyl-human-serum-albumin-liver-scintigraphy
#8
Takafumi Sato, Junichi Arita, Yosuke Inoue, Rintaro Koga, Yu Takahashi, Akio Saiura
Preoperative evaluation of liver functional reserve is important in hepatobiliary surgery. Although the indocyanine green retention rate at 15 minutes (ICG-R15) is the gold standard for this purpose, a new method without technical complexity would be preferable. We assessed the usefulness of the previously established index of convexity (IOC). In total, 159 consecutive patients who underwent both technetium-99m-galactosyl human serum albumin ((99m)Tc-GSA) scintigraphy and the ICG-R15 were included. Correlation coefficients between indices from (99m)Tc-GSA scintigraphy and blood examinations including ICG-R15 were evaluated, and a conversion formula from the IOC to the ICG-R15 was established...
May 8, 2017: Bioscience Trends
https://www.readbyqxmd.com/read/28483680/preoperative-gadoxetic-acid-enhanced-mri-for-predicting-microvascular-invasion-in-patients-with-single-hepatocellular-carcinoma
#9
Sunyoung Lee, Seong Hyun Kim, Ji Eun Lee, Dong Hyun Sinn, Cheol Keun Park
BACKGROUND & AIMS: This study aimed to identify preoperative magnetic resonance (MR) imaging biomarkers for predicting microvascular invasion (MVI) and to determine their diagnostic performance and evaluate whether they are associated with early recurrence after surgery for single hepatocellular carcinoma (HCC). METHODS: The study included 197 patients with surgically resected HCC (≤ 5 cm) who underwent preoperative gadoxetic acid-enhanced MR imaging. Significant MR imaging findings for predicting MVI were identified on univariate and multivariate analyses...
May 5, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28464579/-clinical-study-on-the-relationship-between-pancreatic-fistula-and-the-degree-of-pancreatic-fibrosis-after-pancreatic-and-duodenal-resection
#10
M W Yang, Y Deng, T Huang, L D Zhang
Objective: To explore the risk factors of pancreatic fistula after pancreatoduodenectomy and its relationship with pancreatic fibrosis. Methods: Retrospective analysis was made including 408 patients who underwent pancreaticoduodenectomy from January 2013 to December 2015 in Department of Hepatobiliary Surgery of the First Affiliated Hospital of Third Military Medical University. There were 274 males and females, aging from 14 to 82 years with an average age of 54.6 years. Postoperative pathological diagnosis: 285 cases with pancreatic ductal adenocarcinoma, 81 cases with gastrointestinal tumors, 13 cases with neuroendocrine tumors, 16 cases with inflammatory changes, 8 cases with pancreatic papillary tumors, 4 cases with serous cystadenoma, 1 case with retroperitoneal liposarcoma...
May 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28457337/c-reactive-protein-as-early-predictor-of-complications-after-minimally-invasive-colorectal-resection
#11
Corrado Pedrazzani, Margherita Moro, Guido Mantovani, Enrico Lazzarini, Simone Conci, Andrea Ruzzenente, Giuseppe Lippi, Alfredo Guglielmi
BACKGROUND: Minimally invasive surgery (MIS) and enhanced recovery programs have been increasingly adopted in colorectal surgery. The aim of this prospective observational study was to evaluate the usefulness of the C-reactive protein (CRP) concentration measured on postoperative day 3 (POD-3) as an early predictor of severe complications after minimally invasive colorectal resection. MATERIALS AND METHODS: From January 2014 to December 2015, 160 patients underwent resection of colorectal disease by MIS at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28455251/triphasic-dynamic-contrast-enhanced-computed-tomography-in-the-differentiation-of-benign-and-malignant-gallbladder-polypoid-lesions
#12
Wei Zhou, Guichen Li, Ling Ren
OBJECTIVE: With triphasic dynamic contrast-enhanced CT scan to identify benign and malignant gallbladder polypoid lesions, we hope to find out an accurate diagnosis before surgery. MATERIALS AND METHODS: Ninety patients with gallbladder polypoid lesions were treated surgically in Department of Hepatobiliary Surgery, the First Affiliated Hospital of China Medical University (Shenyang, China) from July 2013 to July 2016, and divided into malignant group with 44 patients, and benign group with 46, according to postoperative pathological results...
April 25, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28452912/effects-of-a-brief-team-training-program-on-surgical-teams-nontechnical-skills-an-interrupted-time-series-study
#13
Brigid M Gillespie, Emma Harbeck, Evelyn Kang, Catherine Steel, Nicole Fairweather, Kriengsak Panuwatwanich, Wendy Chaboyer
BACKGROUND: Up to 60% of adverse events in surgery are the result of poor communication and teamwork. Nontechnical skills in surgery (NOTSS) are critical to the success of surgery and patient safety. The study aim was to evaluate the effect of a brief team training intervention on teams' observed NOTSS. METHODS: Pretest-posttest interrupted time-series design with statistical process control analysis was used to detect longitudinal changes in teams' NOTSS. We evaluated NOTSS using the revised NOTECHS weekly for 20 to 25 weeks before and after implementation of a team training program...
April 27, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28447062/modified-palliative-biliary-stenting-in-situs-inversus-totalis-patient-with-carcinoma-gallbladder-feasibility-and-technical-details
#14
Nishant Gupta, Pradeep Goyal, Itisha Bansal, Shuo Li, Yogesh Kumar, Sanjay S Baijal
Knowledge of the anatomical variants is essential for all invasive hepatobiliary procedures such as endoscopy, surgery and radiologic interventions. Modification in standard therapeutic interventions may be required based on variant anatomy. We report a technical modification in a 75-year-old female with known situs inversus (SI) totalis with carcinoma gallbladder. Present case highlights the finer technical details of the modified percutaneous transhepatic biliary drainage (PTBD) procedure and biliary stenting in a SI patient with carcinoma gallbladder causing malignant biliary obstruction...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28415937/heparinized-saline-versus-normal-saline-for-maintaining-peripheral-venous-catheter-patency-in-china-an-open-label-randomized-controlled-study
#15
Lichun Xu, Yan Hu, Xiaojin Huang, Jianguo Fu, Jinhui Zhang
Objective To evaluate the effects of heparin saline versus normal saline as locking solution for maintaining patency in peripheral venous catheters in Chinese patients. Methods This open-label, randomized controlled study was conducted in two hepatobiliary surgery wards, where patients received identical treatments, at a tertiary referral hospital. Patients were randomly divided into a normal saline group (NS, 3 ml) or a heparin saline group (HS, 50 IU/ml, 3 ml) for catheter sealing. Results The study enrolled 286 patients and 609 peripheral venous catheters were included in the analysis...
April 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28412043/assessment-of-high-priced-systemic-antifungal-prescriptions
#16
C Poulat, Y Nivoix, A Launoy, P Lutun, P Bachellier, S Rohr, M-L Woehl, D Levêque, V Bru, R Herbrecht, B Gourieux
OBJECTIVES: To assess compliance with international guidelines for costly antifungal prescriptions and to compare these results with a first study performed in 2007. METHODS: Retrospective study including all costly antifungal prescriptions made in surgical and medical intensive care units and in a hepatobiliary, pancreatic, and digestive surgery unit. Prescriptions were assessed in terms of indication, dosage, and antifungal de-escalation. RESULTS: Seventy-four treatments were analyzed...
April 12, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28392502/contrast-enhanced-computed-tomography-plus-gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic-acid-enhanced-magnetic-resonance-imaging-for-gross-classification-of-hepatocellular-carcinoma
#17
Chuang Chen, Hui Zhao, Xu Fu, LuoShun Huang, Min Tang, XiaoPeng Yan, ShiQuan Sun, WenJun Jia, Liang Mao, Jiong Shi, Jun Chen, Jian He, Jin Zhu, YuDong Qiu
Accurate gross classification through imaging is critical for determination of hepatocellular carcinoma (HCC) patient prognoses and treatment strategies. The present retrospective study evaluated the utility of contrast-enhanced computed tomography (CE-CT) combined with gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) for diagnosis and classification of HCCs prior to surgery. Ninety-four surgically resected HCC nodules were classified as simple nodular (SN), SN with extranodular growth (SN-EG), confluent multinodular (CMN), or infiltrative (IF) types...
May 2, 2017: Oncotarget
https://www.readbyqxmd.com/read/28366422/efficacy-and-safety-of-postoperative-anticoagulation-prophylaxis-with-enoxaparin-in-patients-undergoing-pancreatic-surgery-a-prospective-trial-and-literature-review
#18
Daisuke Hashimoto, Shigeki Nakagawa, Naoki Umezaki, Takanobu Yamao, Yuki Kitano, Kensuke Yamamura, Takayoshi Kaida, Kota Arima, Katsunori Imai, Yo-Ichi Yamashita, Akira Chikamoto, Hideo Baba
BACKGROUND: /Objectives: Enoxaparin is low-molecular-weight heparin that is used for postoperative thromboprophylaxis. The purpose of this study was to evaluate the efficacy and safety of enoxaparin after pancreatic resection. We additionally carried out a literature review regarding venous thromboembolism (VTE) and postoperative bleeding mainly after hepatobiliary-pancreatic surgery. METHODS: This was a prospective, single-arm study. Patients aged 20-79 years who planned to undergo pancreatic resection followed by postoperative anticoagulation therapy with enoxaparin were enrolled from 2013 to 2016...
March 29, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28365947/irreversible-electroporation-nanoknife%C3%A2-treatment-in-the-field-of-hepatobiliary-surgery-current-status-and-future-perspectives
#19
Georgios Kourounis, Patrick Paul Tabet, Demetrios Moris, Alexandros Papalambros, Evangelos Felekouras, Fanourios Georgiades, George Astras, Athanasios Petrou
PURPOSE: We aimed to provide an overview of current understanding on the potential use of irreversible electroporation (IRE) in the field of hepatobiliary surgery with a focus on current results in hepatic and pancreatic cancers, its limitations, and its current directions. METHODS: Through a review of the literature we have gathered the key articles and trials that are shaping our understanding of the current status of IRE and its prospective uses, and organized them in an easily understandable format showcasing the most up to date results...
January 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28365891/the-liver-hanging-maneuver-in-laparoscopic-liver-resection-a-systematic-review
#20
REVIEW
Rami Rhaiem, Tullio Piardi, Tarek Kellil, Audrey Cagniet, Mikael Chetboun, Reza Kianmanesh, Daniele Sommacale
PURPOSE: Laparoscopic surgery has gained the acceptance of the hepatobiliary surgical community and expert teams are now advocating major laparoscopic liver resections (LLRs). In this setting, the liver hanging maneuver (LHM) has been described in numerous series. We conducted a systematic review to investigate the effectiveness of the LHM in LLR. METHODS: We performed an electronic literature search using PubMed, EMBASE, and COCHRANE databases. The final search was carried out in December, 2015...
April 1, 2017: Surgery Today
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